Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
BMJ Open. 2022 May 12;12(5):e060885. doi: 10.1136/bmjopen-2022-060885.
To document lessons from the Global Polio Eradication Initiative (GPEI) by determining factors associated with successful surveillance programme globally as well as at national and subnational levels. The process of conducting surveillance has been previously recognised in the literature as important for the success of polio surveillance activities.
A cross-sectional survey with closed and open-ended questions.
Survey of persons involved in the implementation of surveillance activities under the GPEI at the global level and in seven low-income and middle-income countries.
Individuals (n=802) with ≥12 months of experience implementing surveillance objective of the GPEI between 1988 and 2019.
Quantitative and qualitative analyses were conducted. Logistic regression analyses were used to assess factors associated with implementation process as a factor for successful surveillance programme. Horizontal analysis was used to analyse qualitative free-text responses on facilitators and barriers identified for conducting surveillance activities successfully.
Overall, participants who reported challenges relating to GPEI programme characteristics had 50% lower odds of reporting implementation process as a factor for successful surveillance (adjusted OR (AOR): 0.50, 95% CI: 0.29 to 0.85). Challenges were mainly perceptions of external intervention source (ie, surveillance perceived as 'foreign' to local communities) and the complexity of surveillance processes (ie, surveillance required several intricate steps). Those who reported organisational challenges were almost two times more likely to report implementation process as a factor for successful surveillance (AOR: 1.89, 95% CI: 1.07 to 3.31) overall, and over threefolds (AOR: 3.32, 95% CI: 1.14 to 9.66) at the national level.
Programme characteristics may have impeded the process of conducting surveillance under the GPEI, while organisational characteristics may have facilitated the process. Future surveillance programmes should be designed with inputs from local communities and frontline implementers.
通过确定与全球、国家和次国家层面成功监测计划相关的因素，记录全球根除脊髓灰质炎倡议（GPEI）的经验教训。监测过程在文献中被认为对脊灰监测活动的成功很重要。
一项采用封闭式和开放式问题的横断面调查。
在全球范围内以及在七个低收入和中等收入国家中，调查参与 GPEI 监测活动实施的人员。
1988 年至 2019 年间，有≥12 个月实施 GPEI 监测目标经验的个人（n=802）。
进行定量和定性分析。采用逻辑回归分析评估与实施过程相关的因素，将其作为成功监测计划的因素。采用水平分析方法分析成功开展监测活动所确定的促进因素和障碍的定性自由文本答复。
总体而言，报告与 GPEI 项目特征相关挑战的参与者，报告实施过程作为成功监测因素的可能性降低 50%（调整后的比值比（AOR）：0.50，95%CI：0.29 至 0.85）。挑战主要是对外部干预来源的看法（即监测被视为当地社区的“外来”）和监测过程的复杂性（即监测需要几个复杂的步骤）。报告组织挑战的参与者，报告实施过程作为成功监测因素的可能性总体上增加近两倍（AOR：1.89，95%CI：1.07 至 3.31），在国家层面增加三倍以上（AOR：3.32，95%CI：1.14 至 9.66）。
项目特征可能会阻碍 GPEI 下的监测过程，而组织特征可能会促进该过程。未来的监测计划应在当地社区和一线实施者的参与下进行设计。
